Qiong Duan,1,* Mingyu Sun,2,* Desheng Kong,3,* Jun Liu,4 Bo Liu,5 Kelin Li6 

1Department of Plastic Surgery, The Fifth Clinical Medical College of Henan University of Chinese Medicine (Zhengzhou People’s Hospital), Zhengzhou, 450003, People’s Republic of China; 2Department of Breast Surgery, Xuzhou Central Hospital. The Affiliated Xuzhou Hospital of Medical College of Southeast University, Xuzhou, 221009, People’s Republic of China; 3Emergency Surgery Department of Zhengzhou Hospital of Traditional Chinese Medicine, Zhengzhou, 450001, People’s Republic of China; 4Department of Orthopedic Surgery, Xuzhou Central Hospital, The Affiliated Xuzhou Hospital of Medical College of Southeast University, Xuzhou, 221009, People’s Republic of China; 5Department of Ultrasound, Henan Provincial Maternal and Child Health Care Hospital, the Third Affiliated Hospital of Zhengzhou University, Zhengzhou, 450001, People’s Republic of China; 6Department of Burn Plastic Surgery, The First People’s Hospital of Yulin, Yulin, 537000, People’s Republic of China

*These authors contributed equally to this work

Correspondence: Jun Liu, Email 77998306@qq.com

Purpose: This study evaluated the knowledge, attitude, and practice (KAP) of breast surgery healthcare professionals in China towards breast reconstruction.
Patients and Methods: This multicenter cross-sectional study was performed between July and September 2024, recruiting breast surgery healthcare professionals across China. Data were collected using a self-administered questionnaire with high reliability (Cronbach’s α = 0.915) to capture demographic and KAP information. Multivariate logistic analyses identified factors independently associated with the KAP.
Results: A total of 371 participants were enrolled. The mean knowledge, attitude, and practice scores were 8.25± 3.67, 43.77± 6.25, and 25.56± 4.77. Working at a teaching hospital (OR=7.019, 95% CI: 2.519– 19.562, P< 0.001) and performing or participating in breast reconstruction surgery for patients (OR=4.128, 95% CI: 2.170– 7.853, P< 0.001) were independently associated with adequate knowledge. The knowledge scores (OR=1.093, 95% CI: 1.019– 1.173, P=0.013), female gender (OR=3.774, 95% CI: 1.959– 7.279, P< 0.001), master’s degree or above education (OR=5.597, 95% CI: 2.050– 15.284, P=0.001), non-public tertiary hospitals (OR=8.196, 95% CI: 2.368– 28.363, P=0.001), > 20 years of experience (OR=11.249, 95% CI: 1.554– 81.443, P=0.017), teaching hospital (OR=3.367, 95% CI: 1.262– 8.980, P=0.015), and performed or participated in breast reconstruction surgery for patients (OR=2.228, 95% CI: 1.041– 4.769, P=0.039) were independently associated with the positive attitude. The knowledge scores (OR=1.176, 95% CI: 1.095– 1.262, P< 0.001), doctor (OR=3.502, 95% CI: 1.025– 11.971, P=0.046), master’s degree or above education (OR=0.116, 95% CI: 0.043– 0.313, P< 0.001), junior title (OR=0.194, 95% CI: 0.052– 0.730, P=0.015), non-public tertiary hospitals (OR=0.225, 95% CI: 0.078– 0.650, P=0.006), and 10– 20 years of experience (OR=0.318, 95% CI: 0.109– 0.924, P=0.035) were independently associated with the proactive practice. Structural equation modeling showed that knowledge significantly influenced both attitudes (β=− 1.753, P< 0.001) and practices (β=1.981, P< 0.001).
Conclusion: While attitudes and practices were generally positive, significant gaps remain in routine recommendation and education practices. Targeted educational programs may enhance their knowledge and improve clinical practices.

Keywords: knowledge, attitude, practice, breast cancer, breast reconstruction, healthcare professionals